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Multicenter phase II study of bimonthly high-dose leucovorin, fluorouracil infusion, and oxaliplatin for metastatic colorectal cancer resistant to the same leucovorin and fluorouracil regimen
Author(s): Andre T, Bensmaine MA, Louvet C, Francois E, Lucas V, Desseigne F, Beerblock K, Bouche O, Carola E, Merrouche Y, Morvan F, Dupon-Andre G, de Gramont A
Source: JOURNAL OF CLINICAL ONCOLOGY    Volume: 17    Issue: 11    Pages: 3560-3568    Published: NOV 1999  
Times Cited: 179     References: 25     
Abstract: Purpose: To evaluate the objective tumor response rates and toxicities of leucovorin (LV) plus fluorouracil (5-FU) cancer regimen combined with oxaliplatin (85 mg/m(2)) every 2 weeks on metastatic colorectal cancer patients with documented proof of progression while on bimonthly LV and 5-FU alone,

patients and Methods: One hundred patients were enrolled onto this study and 97 received the study drugs between October 1995 and December 1996. Eighty-nine patients were eligible for per-protocol efficacy analysis with documented proof of progression on one of the following two treatments: LV 500 mg/m(2) and continuous 5-FU infusion 1.5 to 2 g/m(2)/22 hours, days 1 through 2 every 2 weeks (FOLFUHD); or LV 200 mg/m(2), bolus 5-FU 400 mg/m2, and continuous 5-FU infusion 600 mg/m(2)/22 hours, days 1 through 2 every 2 weeks [LV5FU2). in our study, 40 patients received FOLFUHD + 85 mg/m(2) of oxaliplatin day 1 (FOLFOX3) and 57 patients received LV5FU2 + 85 mg/m(2) of oxaliplatin day 1 (FOLFOX4).

Results: Of the 97 patients treated, 20 partial responses were observed (FOLFOX3/4: response Kite, 20.6%; 95% confidence interval, 13% to 31.1%; FOLFOX3: response rate,18.4%; FOLFOX4: response rate, 23.5%). For patients treated with FOLFOX3/4, the median response duration for was 7.5 months, and the major toxicities were peripheral neuropathy and neutropenia. The incidence of grade 3 (National Cancer Institute common toxicity criteria) peripheral neuropathy was 20.6%; whereas the overall incidence of grade 3 to 4 neutropenia wets 27.8%, 15%, and 36.9% for FOLFOX3/4, FOLFOX3, and FOLFOX4 respectively (P = .02). From the start of treatment, median progression-free survival was 4.7, 4.6, and 5.1 months for FOLFOX3/4, FOLFOX3, FOLFOX4, respectively, and median overall survival was 10.8, 10.6, and 1 1,1 months, respectively.

Conclusion: This phase II study of oxaliplatin at 85 mg/m(2) in combination with bimonthly LV plus 5-FU in patients with colorectal cancer resistant to LV plus 5-FU atone confirms the enhanced antitumor activity of oxaliplatin in combination with 5-FU. (C) 1999 by American Society of Clinical Oncology.

Document Type: Article
Language: English
Reprint Address: Andre, T (reprint author), Hop Tenon, Med Oncol Serv, 4 Rue Chine, F-75970 Paris 20, France
Addresses:
1. Hop Tenon, Med Oncol Serv, F-75970 Paris 20, France
2. Hop St Antoine, Clin Mont Louis, F-75571 Paris, France
3. Hop St Antoine, GERCOR, F-75571 Paris, France
4. Sanofi Winthrop, Gentilly, France
5. Ctr Antoine Lacassagne, F-06054 Nice, France
6. Hop Source, Orleans, France
7. Ctr Leon Berard, F-69373 Lyon, France
8. CHU Reims, Reims, France
9. Ctr Hosp Senlis, Senlis, France
10. Ctr Hosp Reg Besancon, Besancon, France
11. Ctr Hosp Rene Dubos, Pontoise, France
Publisher: W B SAUNDERS CO, INDEPENDENCE SQUARE WEST CURTIS CENTER, STE 300, PHILADELPHIA, PA 19106-3399 USA
Subject Category: Oncology
IDS Number: 251YJ
ISSN: 0732-183X
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